滑脉主痰，或伤于食。下为蓄血，上为吐逆。
痰乃水饮所结，薄则稠粘，老则 。滑脉，滑泽近于水象，如数疾而替替然，
形相似也。不腐不化之食，象亦如之，皆有物之脉也。（痰宜二陈汤；食宜丹溪保和丸，洁古枳术
丸、曲 枳术丸之类。）在下则见于尺。主蓄血者，血亦类液，瘀凝类痰，以其在尺，故以
血断。（宜仲景桃核承气汤、《准绳》代抵当丸之类。）若见于寸，必主吐逆，盖因滑脉之流利滑
动，势不安定，切近上焦，自当为吐。（宜六君子汤、仲景大半夏汤、温胆汤、东垣藿香安胃散之类。）然
而所吐之物，非痰即食。设无痰食，是为呕逆，则脉不应见滑，而又当见涩矣。
二陈汤（见第十六）
丹溪保和丸（见第十七）
洁古枳术丸（见第十七）
曲 枳术丸 治强食所致，心胸满闷不快。
神曲（炒） 麦 （炒） 枳实（去瓤、麸炒，各一两） 白术（炒，二两）
上制，服如枳术丸法。
仲景桃核承气汤 《伤寒论》云∶太阳病不解，热结膀胱，其人如狂。血自下，下
者愈。其外不解者，尚未可攻，当先解外。外解已，但少腹急结者，乃可攻之。
宜桃核承气汤。此下热与血结成瘀之剂也。今用下瘀血于肠腹胁下者，皆效。
桃仁（五十个，去皮尖，味甘平） 桂枝（二两，去皮，味辛热） 大黄（四两） 芒硝（二两）
甘草（二两，炙）
上五味，以水七升，煮取二升半。去滓，内芒硝。更上火，微沸下火。先食温
服五合。日三服。当微利。
准绳代抵当丸 行瘀血。（自制。）
大黄（川产、如锦纹者，去皮及黑心，四两） 芒硝（一两。如欲稳，以玄明粉代） 桃仁（麸炒黄，
去皮尖，另研如泥，六十枚） 当归尾 生地黄 穿山甲（蛤粉炒，各一两） 桂（三钱或五钱）
上为极细末，炼蜜丸如桐子大。若蓄血在上焦，丸如芥子大。临卧去枕仰卧，
以津咽之，令停留喉下，搜逐膈上。中焦食远，下焦空心。俱桐子大，以百涝水煎汤下之。
用归地者，欲下血而不损血耳，且引诸药至血分也。诸药皆犷悍，而欲以和济之
也。如血老成积，此药攻之不动，宜去归地，加广术（醋浸透、焙干、一两） 肉桂（七钱）
六君子汤 （见第十六）
仲景大半夏汤 治反胃呕吐。
半夏（二升洗） 人参（三两） 白蜜（一升）
以水一斗三升，和蜜，扬之二百四十遍。煮药取三升，温服一升，余分再服。
温胆汤（三因） 治心胆虚怯，触事易惊，或梦寐不祥，遂致心惊胆慑，气郁生涎。
涎与气搏，变生诸证。或短气悸乏，或复自汗。
半夏（汤洗） 枳实 竹茹（各一两） 橘皮（一两半去白） 甘草（炙四钱） 白茯苓（七钱）
每服四钱。水一盏半，生姜七片，枣一枚，煎七分，食前热服。
东垣藿香安胃散 治脾胃虚弱，不进饮食，呕吐不待腐熟。
藿香（一钱半） 丁香 人参（各二钱） 橘红（五钱）
上为细末，每服二钱。水二盏，生姜三片，同煎至一盏，去滓凉服，食前。和滓服亦可。
滑脉主要主痰证，或者是饮食积滞所致。病位在下焦则为蓄血，病位在上焦则为呕吐逆气。
痰是水饮凝结而成，质地稀薄时变得稠粘，日久则更加胶固。滑脉的形态，滑利润泽近于水的象，如数疾而跳动有力（替替然），形状相似。不腐不化之食物，其脉象也与此相似，都是有形实邪阻滞的脉象。（痰证适宜用二陈汤；食积适宜用丹溪保和丸、洁古枳术丸、神曲枳术丸之类。）若滑脉见于尺部，主蓄血者，因为血亦属于液类，瘀凝的状态类似痰，因其出现在尺部，所以断定为血证。（适宜用仲景桃核承气汤、《准绳》代抵当丸之类。）若滑脉见于寸部，必定主呕吐逆气，这是因为滑脉流利滑动，气势不安定，切诊部位靠近上焦，自然应当表现为呕吐。（适宜用六君子汤、仲景大半夏汤、温胆汤、东垣藿香安胃散之类。）然而所吐出的东西，不是痰就是食物。如果没有痰和食积，而是单纯的呕逆，那么脉象不应当见滑，而应当见涩脉了。
二陈汤（见第十六章）
丹溪保和丸（见第十七章）
洁古枳术丸（见第十七章）
神曲枳术丸 治疗因强食（暴饮暴食）所致的心胸满闷不快。
神曲（炒制） 麦芽（炒制） 枳实（去瓤、麸炒，各一两） 白术（炒制，二两）
以上药物制成丸剂，服用方法同枳术丸法。
仲景桃核承气汤 《伤寒论》说：太阳病不解，热邪结于膀胱，其人出现如狂的症状。瘀血自下，下后病愈。如果表证未解，尚不可攻里，应当先解表。表解之后，仅存少腹急结者，才可攻里。
适宜用桃核承气汤。这是攻下热与血结成瘀的方剂。如今用于攻下肠腹胁下的瘀血，都有效。
桃仁（五十个，去皮尖，味甘平） 桂枝（二两，去皮，味辛热） 大黄（四两） 芒硝（二两）
甘草（二两，炙制）
以上五味药，用水七升，煮取二升半。去渣，加入芒硝。再次上火，微沸后去火。饭前温服五合。每日三次服。应当轻微通利。
准绳代抵当丸 行瘀血。（自制方。）
大黄（川产、纹理如锦纹者，去皮及黑心，四两） 芒硝（一两。如果想要稳妥，可用玄明粉代替） 桃仁（麸炒黄，去皮尖，另研如泥，六十枚） 当归尾 生地黄 穿山甲（蛤粉炒，各一两） 桂枝（三钱或五钱）
以上药物研为极细末，炼蜜为丸，如梧桐子大。若蓄血在上焦，丸剂如芥子大。临睡前去枕仰卧，以津液送服，令药停留喉下，搜逐膈上瘀血。中焦病在食后服，下焦病空腹服。均用梧桐子大，以百劳水煎汤送下。使用归地和生地，是为了下血而不伤血，且引导诸药至血分。诸药皆刚猛，而欲以柔和之品济助它们。如血老成积，此药攻之不动，宜去掉归地，加莪术（醋浸透、焙干、一两） 肉桂（七钱）。
六君子汤 （见第十六章）
仲景大半夏汤 治疗反胃呕吐。
半夏（二升，洗净） 人参（三两） 白蜜（一升）
用水一斗三升，和入蜂蜜，扬之二百四十遍。煮药取三升，温服一升，剩余分两次服。
温胆汤（出自《三因极一病证方论》） 治疗心胆虚怯，遇事易惊，或梦寐不祥，遂致心惊胆慑，气郁生涎。
涎与气搏结，变生各种证候。或短气悸乏，或复发自汗。
半夏（汤洗） 枳实 竹茹（各一两） 橘皮（一两半，去白） 甘草（炙制四钱） 白茯苓（七钱）
每服四钱。水一盏半，生姜七片，枣一枚，煎至七分，食前热服。
东垣藿香安胃散 治疗脾胃虚弱，不进饮食，呕吐不待腐熟。
藿香（一钱半） 丁香 人参（各二钱） 橘红（五钱）
以上药物研为细末，每服二钱。水二盏，生姜三片，同煎至一盏，去渣凉服，食前服用。连渣服用也可以。
The slippery pulse (Hua Mai, slippery pulse) primarily indicates phlegm (Tan, phlegm) or food retention (Shi, food stagnation). When located in the lower jiao, it signifies blood stasis (Xu Xue, accumulated blood); when located in the upper jiao, it indicates vomiting and regurgitation.
Phlegm is formed by the concretion of fluid retention; when thin, it becomes thick and sticky, and with age, it becomes more consolidated. The morphology of the slippery pulse is smooth, lustrous, and resembles water, beating rapidly and vigorously (ti ti ran), similar in shape to the description above. Undigested food also presents a similar pulse image, both being pulses associated with tangible pathogenic factors. (For phlegm, Er Chen Tang (Two-Cured Decoction) is suitable; for food retention, Danxi Baohe Wan (Danxi Harmonizing Pill), Jiegu Zhi Zhu Wan (Jiegu Immature Bitter Orange and Atractylodes Pill), Qu Zhi Zhu Wan (Qu Immature Bitter Orange and Atractylodes Pill), etc., are suitable.) If the slippery pulse appears at the chi position (cun-chi pulse positions: cun=inch, guan=bar, chi=cubit; chi corresponds to the lower jiao/kidneys), it indicates blood stasis. Blood is also a type of fluid, and its coagulation resembles phlegm; because it appears at the chi position, it is diagnosed as a blood disorder. (Zhongjing Taohe Chengqi Tang (Peach Kernel Decoction to Direct the Qi Downward) from Zhang Zhongjing, and Dai Dang Wan (Substitute Dang Pill) from *Zhunsheng* are suitable.) If the slippery pulse appears at the cun position, it must indicate vomiting and regurgitation. This is because the slippery pulse is smooth and flowing, with an unstable momentum; since the palpation site is close to the upper jiao, it naturally manifests as vomiting. (Liujunzi Tang (Six-Gentlemen Decoction), Zhongjing Banxia Shenyang Tang (Large Pinellia Decoction to Nourish the Stomach), Wendan Tang (Warming the Gallbladder Decoction), and Dongyuan Huoxiang Anwei San (Dongyuan Patchouli Decoction to Calm the Stomach) are suitable.) However, the vomitus consists either of phlegm or food. If there is no phlegm or food retention, but rather simple vomiting and regurgitation, the pulse should not be slippery, but rather choppy (Se, choppy pulse).
Er Chen Tang (See Chapter 16)
Danxi Baohe Wan (See Chapter 17)
Jiegu Zhi Zhu Wan (See Chapter 17)
Qu Zhi Zhu Wan Treats chest and epigastric fullness and discomfort caused by overeating.
Shenqu (Fermented Mass, stir-fried) Maiya (Malt, stir-fried) Zhishi (Immature Bitter Orange, remove pith and stir-fry with bran, each 1 liang) Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried, 2 liang)
Process into pills, administer according to the method for Zhi Zhu Wan.
Zhongjing Taohe Chengqi Tang (*Shanghan Lun* states:) "When Taiyang disease is unresolved, heat binds in the Bladder, and the person exhibits manic behavior. If blood passes spontaneously downward, the patient heals. If the exterior syndrome is not yet resolved, internal purgation is not yet indicated; one should first resolve the exterior. Once the exterior is resolved, if only urgency and binding in the lower abdomen remain, then purgation may be applied."
Taohe Chengqi Tang is suitable. This is a formula that purges heat and blood congealed into stasis. It is now effective for expelling blood stasis in the intestines, abdomen, and hypochondrium.
Taoren (Peach Kernel, remove skin and tips, sweet, neutral, 50 pieces) Guizhi (Cinnamon Twig, remove bark, acrid, hot, 2 liang) Dahuang (Rhubarb Root, 4 liang) Mangxiao (Mirabilite, 2 liang) Gancao (Licorice Root, honey-fried, 2 liang)
Take these five herbs, add seven sheng of water, boil to obtain two and a half sheng. Remove the dregs, add Mangxiao. Apply heat again, bring to a slight boil, then remove from fire. Take warm, five he before meals. Administer three times daily. There should be mild purgation.
Zhunsheng Dai Dang Wan Expels blood stasis. (Self-made formula.)
Dahuang (Sichuan origin, with brocade-like patterns, remove skin and black heart, 4 liang) Mangxiao (Mirabilite, 1 liang. For stability, substitute Xuanningfen/Nitrum) Taoren (Peach Kernel, stir-fry with bran until yellow, remove skin and tips, grind separately into paste, 60 pieces) Dangguiwei (Angelica Sinensis Radix Tail) Shengdihuang (Rehmanniae Radix Recens) Chuanshanjia (Pangolin Scale, stir-fry with clam powder, each 1 liang) Guizhi (Cinnamon Twig, 3 qian or 5 qian)
Grind into extremely fine powder, refine honey to make pills the size of paulownia seeds. If blood stasis is in the upper jiao, make pills the size of mustard seeds. Before sleep, remove pillow, lie supine, swallow with saliva to let the medicine stay under the throat, searching out and eliminating stasis above the diaphragm. For middle jiao disorders, take after meals; for lower jiao disorders, take on an empty stomach. All use paulownia seed-sized pills, administered with decoction of Bailao Water (water collected from dew/rain). The use of Danggui and Dihuang is to expel blood without damaging healthy blood, and to guide other herbs to the blood level. All other herbs are harsh, so they are balanced with milder agents. If old blood has formed chronic accumulation and this formula cannot move it, remove Danggui and Dihuang, add Ezhu (Curcuma Rhizoma, soaked in vinegar, dried, 1 liang) Rougui (Cinnamon Bark, 7 qian).
Liujunzi Tang (See Chapter 16)
Zhongjing Banxia Shenyang Tang Treats retroflexion vomiting (Fanwei, vomiting due to gastric obstruction).
Banxia (Pinelliae Rhizoma, 2 sheng, washed) Renshen (Ginseng Radix et Rhizoma, 3 liang) Baimi (White Honey, 1 sheng)
Add thirteen sheng of water and honey, stir/throw up and down two hundred and forty times. Boil the medicine to obtain three sheng. Take one sheng warm, divide the remainder into two doses.
Wendan Tang (From *Sanyin Fang*) Treats deficiency and timidity of the Heart and Gallbladder, easily startled by events, or unpleasant dreams, leading to heart fright and gallbladder fear, qi stagnation generating phlegm-fluid (Xian, thin phlegm).
Phlegm-fluid combats with qi, generating various syndromes. Or shortness of breath and palpitations/fatigue, or spontaneous sweating.
Banxia (Pinelliae Rhizoma, washed with ginger juice) Zhishi (Immature Bitter Orange) Zhuru (Bambusae Caulis in Taeniam, each 1 liang) Chuanpi (Citri Reticulatae Pericarpium, 1.5 liang, remove white pith) Gancao (Licorice Root, honey-fried, 4 qian) Baifuling (Poria, 7 qian)
Take four qian per dose. Add one and a half sheng of water, seven slices of fresh ginger, one jujube. Decoct to seven parts. Take hot before meals.
Dongyuan Huoxiang Anwei San Treats spleen and stomach weakness, inability to eat, vomiting without prior digestion.
Huoxiang (Agastaches Herba, 1.5 qian) Dingxiang (Caryophylli Flos) Renshen (Ginseng Radix et Rhizoma, each 2 qian) Juhong (Citri Reticulatae Pericarpium Rubrum, 5 qian)
Grind into fine powder. Take two qian per dose. Add two zhan of water, three slices of fresh ginger. Decoct to one zhan. Remove dregs and take cool, before meals. Taking with dregs is also acceptable.